Article excerpt

ARLINGTON, VA. -- Steps should be taken to improve mental health care for older adults and close the gap between mental health and primary care, members said at a meeting of the President's New Freedom Commission on Mental Health.

The commission as a whole approved the draft reports of two of its subcommittees--the subcommittee on older adults and the subcommittee on mental health interface with general medicine, which recommended policy changes in both areas. Those policy changes will be included in a major commission report to the president due April 29, along with policy changes recommended by the commission's other mental health subcommittees.

"The number of older. adults with mental illness is expected to double to 15 million in F the next 30 years," Dr. Anil G. Godhole, cochair of the subcommittee on older adults, told the commission. The system currently in place is not equipped to handle the growing needs of this population.

The subcommittee recommended policy options in three areas: improving access and continuity of services, improving quality of services, and developing workforce capacity in geriatric mental health. An overarching policy recommendation included the development of a national leadership partnership in geriatric mental health care with stakeholders in federal government, public and private agencies, and consumers.

"This is a whole population that has been underserved and underappreciated," said Dr. Michael F. Hogan, chair of the commission.

In an effort to improve access to services, the subcommittee recommended that the Department of Health and Human Services update its payment policies to support comprehensive mental health services for older adults in the home and community. HHS and other federal agencies should also work to coordinate mental health services for older adults throughout the community.

Medicare payments should be updated to reflect advances in care and allow timely access to mental health services, the subcommittee said. Current Medicare system policies are not up-to-date with the way care is delivered, subcommittee co-chair Dr. Frances M. Murphy told the commission. It is crucial that psychotropic medications be included in any Medicare prescription drug benefit package, she said.

The subcommittee also highlighted the need to address the stigma about mental health problems in older people. "It is not a normal part of aging to develop depression and other mental health issues," Dr. Murphy said.

Federal agencies should develop screening programs targeted at older adults for depression, suicide, substance abuse, and medication misuse, the committee said in its recommendations to improve access to care. …